Anterior Cruciate Ligament Reconstruction (ACL)

The Anterior Cruciate Ligament (ACL) is a stabilizing ligament in the centre of the knee that is most commonly injured in pivoting sports such as skiing, soccer and basketball, or in contact sports such as football and rugby. A complete tear of the ACL rarely heals on its own and may require surgical reconstruction. Direct repair of the torn ACL is not very successful, therefore a tendon graft is used to reconstruct the ligament. Two small hamstring tendons from your leg, or a portion of your patellar tendon, or an allograft (tendon from a cadaver) are used to make the graft. The majority of the reconstruction surgery is done arthroscopically (through small incisions), and a camera is used to look at all of the knee joint structures.

Learn more about the basics of ACL injury here, compliments of the Banff Sport Medicine Foundation.

ACL Reconstruction Patient Information Video

ACL Reconstruction Rehabilitation Video 4+months

Knee Injuries

Knee Arthroscopy

During a Knee Arthroscopy the surgeon uses a very small camera to look inside the joint. The camera is inserted through a small incision and allows the surgeon to see all of the knee structures. As the surgeon moves the arthroscope around, magnified views are shown on a TV screen. The surgeon can then perform any necessary procedures inside the knee such as trimming or repairing a torn meniscus, performing a lateral release, micro-fracturing damaged bony (articular) cartilage, and cleaning up the joint spaces by removing floating particles of bone or cartilage.

Medial Patellofemoral Ligament (MPFL) Repair/Reconstruction

The Medial Patellofemoral Ligament (MPFL) is a ligament that prevents your patella (knee cap) from dislocating to the outside of your knee. This ligament is commonly injured when you dislocate your patella laterally. Approximately half of all people who dislocate their patella will have ongoing problems with instability. If you have ongoing instability, you may require surgery to repair, tighten (imbricate) or replace (reconstruct) the MPFL. If your anatomy or alignment increase the risk of you dislocating your patella, you may require other surgeries in addition to (but at the same time as) an MPFL surgery.

Tibial Tubercle Transfer – Osteotomy (TTO)

The tibial tubercle is the bony bump on the front of your leg where the tendon from the patella (knee cap) inserts. In tibial tubercle osteotomy surgery (also called tibial tubercle transfer) this tuberosity, with the tendon attached, is cut and shifted. The tubercle is held in its new position with 2 screws made of stainless steel. Moving the tibial tubercle medially (towards the inside of the leg) treats patellar instability by decreasing the lateral pull on the patella. This causes the patella to move in a more correct line and makes it less likely to dislocate. Moving the tibial tubercle anteriorly (forward) can decrease the pain of severe arthritis by removing stress from damaged areas of bony cartilage. Moving the patella distally (down the leg) will also pull down a high riding patella. During the surgery a camera is used to look inside the knee (arthroscopy) to see if the patella is in a better position and also to check for and clean up any damage inside the knee. If your patella is unstable, a tibial tubercle transfer may be done in combination with another patellar stabilizing surgery, such as a medial patellofemoral ligament (MPFL) reconstruction or imbrication.

High Tibial Osteotomy (HTO)

A High Tibial Osteotomy (HTO) is an operation that involves cutting your tibia (shin) bone to realign the weight-bearing axis of the leg. The purpose is to take body weight off an arthritic part of the knee. HTO surgery can also be used in certain cases to treat instability of the knee. When the tibia bone is wedged open, the gap is filled with bone graft. This can come from your pelvis (autograft) or from the bone bank (allograft). Synthetic bone graft can also be used along with, or as an alternative to, the autograft or allograft.